Patient Aligned Care Teams Improve Access and Veteran Satisfaction

The Department of Veterans Affairs’ (VA) Patient Aligned Care Teams (PACTs), VA’s model for more personalized and accessible primary care delivery, is improving access to health care and Veteran satisfaction, according to data released today by the Department of Veterans Affairs.

Since its inception in 2010, the PACT program has transformed the way Veterans receive their care by offering a coordinated team approach squarely focused on Veterans’ wellness and disease prevention.

“Every day, VA works to provide Veterans access to the high-quality health care they have earned and deserve,” said Secretary of Veterans Affairs Eric K. Shinseki. “PACTs provide the right combination of health care professionals to develop a personalized health plan for each Veteran and deliver care conveniently at primary care clinics and through new eHealth options. Through PACTs, VA is achieving more personalized, proactive and patient-driven care. As a result, Veterans are increasingly more satisfied with their care.”

VA is the largest integrated health care system in the United States, caring for approximately 5.3 million Veterans in primary care settings. Over the past two years, VA has bolstered its support to all medical centers to expand established PACTs. Teams are comprised of a provider, a Registered Nurse care manager, a clinical associate, and an administrative associate. Clinical pharmacists, social workers, nutritionists, and behavioral health staff support PACTs.

Since implementing PACTs, the number of primary care patients has increased 12 percent, and the number of encounters with Veterans has increased 50 percent mostly due to telehealth, telephone and group encounters. Communicating with health care professionals through secure electronic means has increased dramatically as well. Despite the increase of primary care patients, access to primary care has improved and continuity of care is better.

Additionally, approximately 65 percent of Veterans requesting a same day primary care appointment with their personal provider are accommodated and 78 percent of Veterans are able to see their own primary care provider for an appointment on the date they desire. Veteran access to primary care during extended hours (non-business hours) has increased 75 percent since January 2013.

Over 72 percent of all Veterans discharged from VA are contacted within two days to ensure they are following discharge instructions and check in on their condition. These critical post-discharge follow-ups are important to reducing readmissions.

Mental Health Integration is also a critical component of PACTs and the program’s goal to provide coordinated care. Veterans now see mental health providers in the primary care setting. In just one year (FY12-FY13) using the PACTs model, mental health services offered in VA primary care clinics increased 18 percent.

Overall, PACTs program implementation has been associated with important utilization changes—fewer primary care patients are receiving care in urgent care settings (decreased 33 percent) and acute hospital admissions have decreased 12 percent due to improved care management and coordination from PACTs.

Equally important, both rural and urban Veterans report a high level of satisfaction with VA services. Veterans also indicated they are more likely to recommend treatment at a VA facility than at non-VA facilities. This positive feedback is consistent with the 2013 American Customer Satisfaction Index, which reported that Veterans strongly endorse VA health care, with 91 percent offering positive assessments of inpatient care and 92 percent for outpatient care.

The PACT model has allowed VA to create COMPASS—a dashboard program which extracts and derives these types of metrics and information from multiple VA sources to track the status of the implementation.

“Our PACTs outcomes to date support VA’s ongoing health care transition to a health system focused on a personalized approach to care. We seek to help every Veteran achieve his or her unique health goals.” said Dr. Robert A. Petzel, VA’s Under Secretary for Health.